British journal of anaesthesia
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We lack evidence on the cumulative effectiveness of machine learning (ML)-driven interventions in perioperative settings. Therefore, we conducted a systematic review to appraise the evidence on the impact of ML-driven interventions on perioperative outcomes. ⋯ CRD42023433163 (PROSPERO).
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Review
Mitigating the systemic loss of nitrous oxide: a narrative review and data-driven practice analysis.
Given the negative health impacts of climate change, clinicians have a fundamental responsibility to take an active role in mitigating the environmental impact of their practices. Inhaled anaesthetics are potent greenhouse gases, including nitrous oxide (N2O), with their long atmospheric lifetime, high global warming potential, and ozone-depleting properties. However, few clinicians realise that losses from central N2O supply systems account for the vast majority of overall N2O consumption in healthcare. ⋯ To date, this mitigation initiative has been successfully implemented at over 25 hospitals in our system. Raising awareness of this considerable source of healthcare-specific N2O emissions empowers clinicians to spearhead facility-level engagement and action. As healthcare leaders, clinicians should advocate for decarbonisation of clinical practices and systems while ensuring high-quality patient care.
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Preoperative fasting is the standard of care for patients undergoing a procedure under general anaesthesia. Despite the increased leniency of fasting guideline recommendations, prolonged preoperative fasting periods continue to disproportionally affect paediatric patients. This review maps existing interventions optimising paediatric fasting practices, to explore strategies that can be best applied in clinical practice. ⋯ A variety of interventions have been studied to optimise paediatric preoperative fasting duration. These interventions show potential in reducing preoperative fasting duration.